The international response to West Africa's Ebola virus disease (EVD) epidemic continued to gain steam today, with the introduction of a government funding bill in the US House of Representatives that earmarks $88 million more to battle the disease and the announcement of a $50 million donation from the Bill & Melinda Gates Foundation to help groups that are working on control efforts.

Last week, Doctors without Borders (MSF), which has been at the forefront of battling the outbreak since it began in March, called on states with biological disaster-response capacity to send civilian and military assets and personnel to West Africa. The World Health Organization (WHO) said on Sep 8 that the outbreak was increasing exponentially and that "nonconventional " interventions are needed.

Government, foundation funding boosts

Yesterday, House Appropriations Chairman Hal Rogers, R-Ky., introduced a continuing resolution to temporarily fund the government beyond the end of the fiscal year, which would avert another shutdown. According to a statement from the committee, the bill includes funds to address the Ebola outbreak, including additional money to speed research on Ebola therapies and more dollars for the Centers for Disease Control and Prevention (CDC) response to the event.

The House bill includes $88 million to battle Ebola, the amount the White House had requested, according to The Hill, a newspaper that covers Congress.

Meanwhile, the Bill & Melinda Gates Foundation said today that it will commit $50 million to help groups scale up their response to the Ebola epidemic. The group said it will immediately release flexible funds to United Nations agencies and international groups involved in the response, according to a press release. The foundation also said it would work with public and private partners to speed the development of drugs, vaccines, and diagnostic tests.

The Gates Foundation said it has already committed $10 million of the total amount, including $5 million to the WHO for emergency operations and research and development assessments and $5 million to the US fund for the UN Children's Fund (UNICEF) for outbreak support efforts in Liberia, Sierra Leone, and Guinea. It said it would immediately send $2 million to the CDC to support its incident management, treatment, and healthcare system strengthening efforts.

Treatment bed update

MSF has said the greatest needs are treatment centers and health workers to staff them, and earlier this week the WHO said there were no more treatment center beds for EVD patients in Liberia and that 1,000 beds were urgently needed, against the backdrop of a rapidly escalating outbreak. It added that the lack of beds was sending sick patients back into the community, increasing the risk of spread the virus to family and neighbors.

In an update on Liberia's treatment center capacity today, the WHO said it and partners have built a new treatment center—Island Clinic in Monrovia—that will open in a few days, with beds for 120 patients. The clinic is a former general health facility that has been transformed into a center that meets WHO safety standards for patients and workers. The agency said work on more centers with the capacity to treat 400 more patients will be completed in the coming weeks.

Meanwhile, a Pentagon plan announced earlier this week to send a $22 million field hospital with the capacity to treat 25 patients to Liberia is drawing some criticism, ScienceInsider reported today.

Tim Flanigan, an American health worker helping in Monrovia, told the magazine that he was initially pleased that the US military was helping, but was disappointed when he learned how few beds the facility had. He said it wouldn't help the treatment situation for Liberians and the beds might be earmarked for foreign workers.

A military official told ScienceInsider that the goal of the field unit is to provide care for infected health workers. Clinical staff have been among the hardest-hit groups in the outbreak, and infections in health workers further erode the capacity to treat sick patients and may discourage other health workers from serving in the outbreak regions.

Calls for medical volunteers grow louder

In other developments, William Pooley, a British nurse who recovered from EVD after getting sick while working in Sierra Leone, said he is going back to the country to continue helping with the outbreak, The Telegraph, a London newspaper, reported today. After he was infected, Pooley was airlifted to Britain, where he was treated with ZMapp in a London hospital.

The call for health workers is becoming more urgent, which prompted an e-mail post on ProMED Mail today asking clinicians to consider volunteering to go to West Africa to coordinate isolation units and supervise local staff. ProMED-mail is the online disease reporting service of the International Society of Infectious Diseases (ISID).

The request was spurred by an e-mail to the group from a clinician working in Sierra Leone who said the situation in Freetown, the capital, is rapidly deteriorating and that the country's two treatment centers are full, pushing patients with suspected infections back into their communities.

Oliver Johnson, MBBS, a clinician from London, said in the e-mail, "Our isolation unit is full with adult and pediatric cases and we have suspected cases in the waiting area and emergency room that we can't isolate--I don't know how much longer the hospital will be able to stay open in these circumstances."

In another ProMED post, Daniel Lucey, MD, MPH, adjunct professor at Georgetown University Medical Center, highlighted an upcoming CDC Ebola training course on personal protective equipment (PPE) and treatment that will take place in Alabama Sep 22 through 24. Lucey has worked in Sierra Leone and will leave for Liberia at the end of September for a 6-week assignment in Liberia with MSF.

The US Agency for International Development (USAID) has also put out a call for health workers to volunteer in West Africa and has an application form at the top of its Web home page. USAID said it is looking for experienced health sector workers who are interested in helping people affected by the Ebola outbreak.

It said contact information will be submitted to USAID's Center for International Disaster Information and may be shared with nongovernmental organizations working in the region or the CDC.